Pharmacogenomics and Biomarkers of Depression

Manish K Jha, Madhukar H Trivedi

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

The standard of care for antidepressant treatment in major depressive disorder (MDD) is a trial-and-error approach. Patients often have to undergo multiple medication trials for weeks to months before finding an effective treatment. Clinical factors such as severity of baseline symptoms and the presence of specific individual (anhedonia or insomnia) or cluster (atypical, melancholic, or anxious) of symptoms are commonly used without any evidence of their utility in selecting among currently available antidepressants. Genomic and proteomic biomarker have gained recent attention for their potential in informing antidepressant medication selection. In this report, we have reviewed some of the major pharmacogenomics studies along with individual genetic and proteomic biomarker of antidepressant response. Additionally, we have reviewed the blood-based protein biomarkers that can inform selection of one antidepressant over another. Among all currently available biomarkers, C-reactive protein (CRP) appears to be the most promising and pragmatic choice. Low CRP (<1Â mg/L) in patients with MDD predicts better response to escitalopram while higher levels are associated with better response to noradrenergic/dopaminergic antidepressants. Future studies are needed to demonstrate the superiority of a CRP-based treatment assignment over high-quality measurement-based care in real-world clinical practices.

Original languageEnglish (US)
Title of host publicationHandbook of Experimental Pharmacology
PublisherSpringer New York LLC
Pages101-113
Number of pages13
DOIs
StatePublished - Jan 1 2019

Publication series

NameHandbook of Experimental Pharmacology
Volume250
ISSN (Print)0171-2004
ISSN (Electronic)1865-0325

Keywords

  • Antidepressant treatment selection biomarkers
  • C-reactive protein
  • Inflammation
  • Major depressive disorder
  • Pharmacogenomics

ASJC Scopus subject areas

  • Biochemistry
  • Pharmacology, Toxicology and Pharmaceutics(all)

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  • Cite this

    Jha, M. K., & Trivedi, M. H. (2019). Pharmacogenomics and Biomarkers of Depression. In Handbook of Experimental Pharmacology (pp. 101-113). (Handbook of Experimental Pharmacology; Vol. 250). Springer New York LLC. https://doi.org/10.1007/164_2018_171